I am a family physician practicing in Toronto, Ontario. I will be implementing an Electronic Medical Record in my practice, starting in March 2006. This blog is a diary of what happened.

Saturday, January 30, 2010

Signing off

The time has come for me to sign off. As you can see in the title, "I will be implementing an Electronic Medical Record in my practice, starting in March 2006. This blog is a diary of what happened". The EMR has now been implemented; my practice has been redesigned to meet goals for patient access (wait times for appointments are now routinely same day or next available clinic day; time sitting in the waiting room is <1/2 hour, we use email with patients), quality (routine measurement and monitoring, regular team meetings), and efficiency. We work as an interdisciplinary team now; these are not just "buzz words", we actually are doing it.

All of us in this primary care team have traveled far along the road to better care for our patients in the past four years, and the EMR has been a key part of this redesign. We will not stop, but I do feel that a large part of the work has now been done. The key issue remaining is that those of us using EMRs continue to function as electronic islands in a sea of paper and systemic inefficiency. We cannot change this from our practices; such a change will take leadership and vision from the people managing our health care system.

As for me, I am finishing my Masters of Science; my thesis "Effect of EMR implementation on preventive services" will be completed this year, and I intend to publish it. I will continue to work three days a week at my office and two days a week on research projects; I think EMRs and quality of care are an important subject, and that is what my research will focus on.

Thank you for bearing with me as I navigated the twists and turns of an EMR implementation in this small community based family practice. It has certainly been challenging at times, but the outcome is more than worth it.

Wow. At last. This is a good project and it will come a long way for sure. I hope people can cope up with this new technology. I know you are busy these days because of implementing and educating the people about your precious work. Good luck on this.

Thanks, John, I appreciate your comments. I also want to say that, as a Canadian, I hope we beat the pants off your hockey team tonight.

I am currently putting the final touches on an research project I have completed, "Effect of EMR implementation on the provision of preventive services". Publication lag is quite long, so it may well be several months before this is published. I will send you a note when it does appear in the academic press.

Thank you for sharing your experience. I hope this helps shed light on what it is like to be involved in the transition.

I wanted to write a blog as well. But you have pretty much shared an intuitive experience for us all.

One of the things I have noticed experimenting with an open source EMR in our office vs. your experiences ... revolves around ASP vs. local.

The beauty of a local server is that you cut out the dependence on the internet.

The only problems we have when the connection is down, is access to eprescriptions. (otherwise, we are able to function as normal). So yes, you won the gold, but here in the states, we have already begun electronic prescriptions for free to US physicians. :^)

But regardless, nice job on the GOLD in hockey and on your blog. Hopefully, you'll be around to continue dialog for the early/middle phase adopters.

This is Hannah Bevills, I am an editor with Hospital.com. We are a medical publication whose focus is geared towards promoting awareness on hospitals, including information, news, and reviews on them. Given the relevance of what you are offering from your site and what our mission is, I feel we may be able to collaborate in some way or another, I look forward to your response regarding the matter. Thanks!